Lasers in Surgery & Medicine -- Reveiw on PreFlushing Pa

[drnase]

Very interesting study. I cant say too much as I am a reviewer ----- yes, contrary to some poorly performed detective work I am an active Peer Review Editor/Consultant for Lasers in Surgery and Medicine under the key words "Laser treatment for Rosacea" and "Laser treatment for Facial Flushing".

One of the big laser gurus performed a split face laser study -- preflushing only one side of rosacea patients faces with severe redness and flushing. The preflushed side only needed 4.5 treatments for full clearance, the other side needed 9.0 treatments. Great study.....all I can say right now. Real clinical study. No opinions. No bias. Just facts.

[drnase]

Good PM question I just received from ESFB group.

Yes, many laser and photoderm specialists get good to excellent results without ever inducing a flush. No question about that. Some also got phenomenol results with the argon laser and 577 nm short pulsed dye lasers which are now extinct. It happens all the time.

The point is ....... ensuring better treatment of redness and flushing that doctors dont always have a full grasp of unless you walk one day in the shoes of a rosacea sufferer who flushes severely or spontaneously every few hours. Push that envelope. Dont close the box. Do not ever become satisfied. Strive for even better.

There are also two well documented microvascular and neurovascular phenomenons that can occur during laser treatment without preflushing the patient.

1. The areas immediately adjacent to the laser spot treatment constrict due to a conducted constrictor response via depolarized vascular smooth muscles. These vessels can stay shut for hours and thus never be treated.

2. The constrictor response that occurs in some patients that experience pain during treatment. For some reason, the pain response activates sympathetic constrictor fibers in some patients and these powerful nerves close multiple layers of vessels and hide them from treatment.

Interesting phenomenon. Wish we could predict which patients this would happen to without active laser doppler readings, the new vascularscope, or a portable confocal system that takes real time imaging of the blood vessels to see if they have been photocoagulated and form thromboses inside.

Good question.

[Bob Bear]

Its great that you people are now beginning to understand resistant cases and what not. It must be so frustrating for those who paid big bucks for IPL and didnt get the results - hopefully with this kind of research these cases will be few and far between.

[drnase]

Its great that you people are now beginning to understand resistant cases and what not. It must be so frustrating for those who paid big bucks for IPL and didnt get the results - hopefully with this kind of research these cases will be few and far between.


To have treatments cut in half is excellent.

[Bob Bear]

Yeh, and that!

When a range of quality preflush topicals become the standard, I may go for a couple myself. Right now there doesnt seem to be much agreement on preflushers (probably since its a 'relatively' recent technique). I know Dr Patterson goes for topical Niacin, but as many have said before it only produces a superficial flush.

I bet this would be another great thing to research down at the ole RRDi. Btw, is this the same as the Oregeon Institute you mentioned previously?

[prryjones]

I bet this would be another great thing to research down at the ole RRDi. Btw, is this the same as the Oregeon Institute you mentioned previously?

I think so, Bob!

[Bob Bear]

I assumed so, but I didnt see any mention of Dr Nase or Oregon on the site - thought it wise to confirm. We all know what assumption is (the mother of all...).

[drnase]

I assumed so, but I didnt see any mention of Dr Nase or Oregon on the site - thought it wise to confirm. We all know what assumption is (the mother of all...).


Hi Bob,

Just to clarify, these are two separate institutions.

[Bob Bear]

Ah, right you are Dr N.